| Novant Health Ballantyne Medical Group | |
|
15825 Ballantyne Medical Place Suite 200 Charlotte NC 28277-3147 | |
| (704) 384-1925 | |
| (704) 384-1930 |
| Full Name | Novant Health Ballantyne Medical Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 15825 Ballantyne Medical Place, Charlotte, North Carolina |
| Authorized Official Name and Position | Leea Jeanine Walton (RCS MANAGER) |
| Authorized Official Contact | 7043166081 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Novant Health Ballantyne Medical Group Po Box 60447 Charlotte NC 28260-0447 Ph: (704) 384-1925 | Novant Health Ballantyne Medical Group 15825 Ballantyne Medical Place Suite 200 Charlotte NC 28277-3147 Ph: (704) 384-1925 |
| NPI Number | 1801898549 |
|---|---|
| Provider Enumeration Date | 08/12/2005 |
| Last Update Date | 07/09/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801898549 | NPI | - | NPPES |
| 89014VG | Medicaid | NC | |
| CC5118 | Other | NC | RR MEDICARE |
| 014VG | Other | NC | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (North Carolina) | Primary |
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